Description: The always popular Medicaid Hot Topics session is back with discussions from an expert panel on the most riveting Medicaid topics of the year. These could include the following: • Medicaid Fiscal Accountability Proposed Regulations• Tennessee's Block Grant Proposal• ACA court battles: What are the potential impacts on Medicaid? • Pass-through payments are converting to directed payments: What is changing?• And more current topics of interest to Medicaid actuariesMedicaid is dynamic and it is difficult to stay current on all of the changes. This session provides insightful discussion into the major changes that impact actuaries and their companies or state clients.

Description: This section presents book reviews and summarizes recent publications on subjects that include U.K. social insurance, financing of hospital care, state examinations of life companies, approximate valuation of life and health insurance, mortality forecasting, and valuing estate tax.

Description: As we entered 2014, actuaries became familiar with three risk stabilizing mechanisms in the early years of the ACA marketplaces, colloquially known as 'the 3Rs'. As we enter 2024, there is renewed focus on rating compliance and risk adjustment. Speakers will highlight pricing considerations when determining cost-sharing reduction premium loads as well as related issues pertaining to risk adjustment and metal tier pricing.

Description: Analyzing large quantities of raw complex data is often a challenge in the health care industry. During this webcast, there will be a demonstration of how unsupervised machine learning techniques can be applied to such data to help bring useful insights. This will include examples that use unsupervised learning techniques spanning dimensionality reduction, clustering and anomaly detection.

Description: The June 2021 Supreme Court ruling in California vs. Texas has significant ramifications on Affordable Care Act markets. This session will provide the actuarial community an overview of the ruling, the likely impact on health insurance markets, and potential legislation to address the ruling details.

Description: This is an introduction to the SOA call for essays around risk strategies pertaining to the diverse risks found in retirement. We are pleased that these essays can be included in this issue of Pension Section News, along with a short interview with each author.

Description: "Advancing health equity is one of the five strategic objectives outlined in the CMS Innovation Center's strategic objectives for the next ten years and is an increasing area of focus across many states. Focus in on recent developments in addressing Medicaid beneficiary needs related to social determinants of health (SDOH), health-related social needs (HRSN), and health disparities and inequities in Medicaid. Several states have introduced non-traditional benefits into their programs in recent years to address these areas, such as various types of housing supports, nutrition-related benefits, and enhanced/advanced case management support. Expect a discussion on the benefits introduced recently in states such as AZ, CA, MA, NC, and OR, including funding considerations around these benefits as well as the 1115 demonstration waiver authorities granted to these states to allow coverage for these non-traditional health care services.

Description: 2021 ImpACT Conference - Session 7B: Premium Alignment in ACA Markets: New Trends in State Guidance 10.27.21 Recording

Description: The Health Insurance Portability and Accountability Act affects all exchanges of health information. It has a major impact on health-care management and the distribution of health information used in underwriting and claim management practices for all medical and non-medical lines. Also discussed are changes to Medicare, Children's Health Insurance Program, CHIP, and a proposed prescription drug plan under Medicare. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 24PD of the Dallas Spring Meeting.

Description: "During the pandemic there has been provider burn out, early retirement, hospital consolidation, and lack of staff in step down facilities. It is taking longer to get appointments. Take a look at the impacts of this andat how this can affect quality ratings in Medicare. You can also explore meeting quality incentives in Medicaid and how the current requirements for these plan to say they have adequate networks. Will the provider shortage have an effect upon actuarial rate certifications? If so, how? Are there any forecasts for how long this shortage will last? What are the impacts to care giving to the Seniors and Medicaid beneficiaries as well as plan design changes? Those who are intermediate level Medicaid and Medicare actuaries are encouraged to attend. By attending this session, you will be able to: Have a good understanding of the current Medicare and Medicaid situation and its impacts Understand strategic ideas of how to keep quality of care and access to care available"